PwC Top Healthcare Trends for 2014

Rethinking roles. Fiscal pressures, sweeping regulatory changes under the Affordable Care Act, and an industry-wide shift to consumerism have given rise to a new health economy. To succeed, some healthcare organizations are reinventing themselves. Insurers are acquiring provider groups. Providers are entering the insurance business. Retailers are expanding their health offerings.

Corporate VC. As traditional venture capital firms become more discerning about which startups to fund, corporations are launching venture arms that are involved in a growing share of healthcare deals. In recent years, corporate venture firms invested more money in biotechnology than any other sector except software.

Private exchanges. As the state exchanges gain traction, private exchanges are drawing their own spotlight as a new way to provide employer-based health benefits and drawing high-profile converts such as IBM, Walgreens, and Sears. The year ahead will shed light on whether more employers will migrate to private exchanges, whether those that have already transitioned will stay with the approach, and how employees will react.

Price transparency. In 2014, comparison shopping for medical care based on price and quality will become easier. Employers are striking exclusive arrangements with providers that deliver high-value care. At the same time, the federal government opened its books on what hospitals bill for relatively common treatments.

Social, mobile, analytics, cloud. Social, mobile, analytics, and cloud technologies are the underpinnings of new business models in which health organizations will be paid based on value rather than volume. In 2014, these technologies will fundamentally alter how health organizations interact with patients and one another to deliver care and manage health while keeping costs down.

Health workforce. An influx of 25 million newly insured patients over the next decade may lead to a physician shortage. Healthcare organizations are adopting technology to deal with the rising demand for services and redefining how medicine is practiced. This changing landscape requires new workforce capabilities that stretch beyond traditional clinical roles by using convenient, consumer-focused technologies.

Clinical trials. In 2014, the health industry comes under increasing pressure to replenish its product pipeline faster and with fewer dollars. To speed up clinical trials and reduce costs, drug developers, device makers and contract researchers are poised to take advantage of alternative approaches for clinical trials, such as adaptive designs and precision medicine.

Healthcare innovation. Faster, cheaper, better. The key to healthcare innovation in 2014 is a tolerance for failure. Companies should view failure as a means to an end to achieve high-impact innovations in less time and at lower cost.

Long-term care. As life expectancy continues to increase, more Americans require a complicated array of long-term care services that do not come cheap. Few people are financially prepared for these expenses, and many will rely on Medicaid to shoulder the costs. The shift toward managed long-term care may be a solution for cost-conscious states, but comes with challenges for insurers and providers entering the field.

Counterfeit drugs. The recently enacted Drug Quality and Security Act establishes a national track and trace program targeting counterfeit medicines. The new law – to be phased in over 10 years – is expected to cost drugmakers $10 million to $50 million. For now, manufacturers should focus on the requirements set to take effect in 2015 and 2017.